Kansas City Moving Forward on Process to Renew Health Levy

KANSAS CITY, Mo. – The campaign to renew a portion of the city’s health levy is set to begin, and it could be a one-sided affair.

On Thursday, the City Council voted unanimously to place the renewal on the April 2 ballot, and supporters of the tax said they would move quickly to begin selling the issue to voters.

They have filed paperwork with the state to establish a fundraising committee and they have retained local political consultant Larry Jacob, a partner with the Dover Group, which spearheaded Sly James’ successful mayoral election in March 2011.

If opponents were taking similar steps, R. Crosby Kemper III said he would likely know about it. But he said he had not heard of any organized opposition.

As executive director of the Kansas City Public Library, Kemper is a critic of financial management at City Hall. He also is chairman of the St. Louis-based Show-Me Institute, which advocates free-market solutions to public policy issues.

Other prominent local conservatives, including pollster Patrick Tuohey, editor of the conservative online journal, The Missouri Record, said they were unaware of any move to counter a pro-tax campaign.

The ballot question will ask voters to renew, for another nine years, a 22-cent property tax that helps support Truman Medical Centers, safety-net clinics, and ambulance service.

First authorized by voters in 2005, the tax generates about $15 million annually to help cover the cost of treating uninsured and underinsured patients.

That city levies the tax on top of its permanent 50-cent health tax. The two combined generate about $50 million in annual revenue.

There was no organized opposition in the low-turnout election of April 2005, where just 12 percent of registered voters cast ballots. The additional levy passed then with 54 percent of the vote.

The task could be easier this time around, Jacob said, since supporters are asking for a renewal instead of a new tax.

“That puts it in a very different light,” he said.

Supporters of renewing the tax said indigent care services continue to need local support, despite ongoing implementation of the federal Affordable Care Act.

For one thing, they said, there is no guarantee that the Missouri General Assembly will expand Medicaid, as the law envisioned.

And even if that does happen, they argued, Medicaid reimbursements don’t come near covering the full cost of care. And Medicaid expansion would still leave some residents without any coverage.

With more than 140,000 visits last year, supporters said, the city’s safety-net network provided service to about one of every 10 residents.

“That is a pretty substantial personal story we can tell,” Jacob said.

Supporters also said the additional health levy helps support an economic engine in the city, with safety-net providers employing more than 8,500 healthcare professionals.

With the tax not set to expire until next year, Tuohey questioned the need to place the question on the ballot in April.

“There is no hurry here,” he said, adding that local healthcare needs could be much clearer after another year of the Affordable Care Act.

But, Jacob said, that uncertainty about the evolving role of state and federal governments in healthcare is exactly why safety-net providers want to lock in at least one funding source they can count on.

Kemper said the seemingly muted opposition to the health levy probably is due to that the fact that it’s one area where the city is doing a “reasonable job” of managing taxpayer money.

That’s not the case, he said, when it comes to fixing the city’s aging sewer system, planning for light rail, or studying the need for a convention hotel downtown.

He also said city voters lately have embraced feel-good issues, such as last year’s vote to impose a half-cent sales tax dedicated to parks and community centers.

“I think healthcare counts as that right now,” he said.

But there appears to be “kind of a natural anti-tax constituency” growing in the city in light of the heavy tax burden shouldered by residents, he said.

Kemper pointed to a 2010 study by the chief financial officer of the District of Columbia, which Congress requires each year to measure the tax burden on residents of that city.

The report listed Kansas City’s tax burden as 12th highest among the nation’s 51 largest cities.

Supporters of renewing the health levy are not resting easy because of the seeming lack of early opposition, Jacob said.

There’s always the possibility that outside anti-tax groups could mount a campaign against renewal.

Tax proponents are mindful of retired St. Louis businessman Rex Sinquefield, who is president of the Show-Me Institute. In 2010, he helped bankroll a statewide initiative that forced Kansas City to seek voter approval every five years to continue its 1 percent earnings tax.

“You have to assume it’s going to be there,” Jacob said of outside money, “and that is what we are doing.”